Healthcare Provider Details
I. General information
NPI: 1184534182
Provider Name (Legal Business Name): MEDSURE SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
771 DEERWOOD DR
STOCKBRIDGE GA
30281-6321
US
IV. Provider business mailing address
771 DEERWOOD DR
STOCKBRIDGE GA
30281-6321
US
V. Phone/Fax
- Phone: 281-942-8054
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
FAHAD
SHAHZAD
Title or Position: COO
Credential:
Phone: 281-942-8054